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Adipose tissue insulin resistance predicts the incidence of hypertension: The Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases

Hypertension Research volume 45, pages 1763–1771 (2022)Cite this article

A Comment to this article was published on 13 September 2022

Abstract

We investigated the association of adipose tissue insulin resistance with blood pressure and hypertension incidence, comparing it with hepatic and skeletal muscle insulin resistance. The cross-sectional analysis included 6892 general health checkup examinees (mean age: 69.3 years; 51.3% women and 48.7% men) who had no cardiovascular disease. Of those, 3948 normotensive participants (mean age: 68.4 years; 54.8% women and 45.2% men) were enrolled in the retrospective cohort analysis. The adipose insulin resistance index (Adipo-IR) was calculated as the product of fasting serum insulin and free fatty acid levels. A high adipo-IR, high homeostasis model assessment of insulin resistance (HOMA-IR), and low Matsuda index were indicated based on the optimal cutoff values in a receiver operating characteristic curve analysis. Adipo-IR (β = 0.096, P < 0.001), HOMA-IR (β = 0.052, P < 0.001), and Matsuda index (β = −0.055, P < 0.001) were associated with systolic blood pressure in the cross-sectional analysis. Over a mean 5.3-year follow-up period, 1310 participants developed hypertension. A high adipo-IR (adjusted OR, 1.29; 95% CI, 1.11–1.51), but not HOMA-IR or Matsuda index, was significantly associated with the incidence of hypertension. Moreover, the combination of high adipo-IR with high HOMA-IR or low Matsuda index showed no higher odds of hypertension than a high adipo-IR alone. These results suggest that insulin resistance is associated with blood pressure control regardless of the tissue in which it occurs; however, the risk of hypertension is determined by insulin resistance in adipose tissue rather than in liver or muscle tissue.

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Acknowledgements

The authors thank Naomi Yuzono for technical and secretarial assistance. This study did not receive any financial support.

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Authors and Affiliations

  1. Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan

    Nobuo Sasaki & Ryo Maeda

  2. Department of Regenerative Medicine, Division of Radiation Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Nobuo Sasaki & Yukihito Higashi

  3. Department of General Medicine, Hiroshima University, Hiroshima, Japan

    Ryoji Ozono

  4. Department of Biostatistics, Medical Center for Translational and Clinical Research, Hiroshima University, Hiroshima, Japan

    Kenichi Yoshimura

  5. Department of Cardiovascular Medicine, Hiroshima University, Hiroshima, Japan

    Yukiko Nakano

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  1. Nobuo Sasaki
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Correspondence to Nobuo Sasaki.

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Sasaki, N., Maeda, R., Ozono, R. et al. Adipose tissue insulin resistance predicts the incidence of hypertension: The Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases. Hypertens Res 45, 1763–1771 (2022). https://doi.org/10.1038/s41440-022-00987-0

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